Articles: postoperative.
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Acta Anaesthesiol Scand · Jul 2014
Comparative Study Observational StudySerum high-mobility group box 1 protein correlates with cognitive decline after gastrointestinal surgery.
Accumulating evidence has indicated that inflammation may act as a potential mechanism underlying post-operative cognitive dysfunction (POCD). High-mobility group box 1 (HMGB1), as a known late mediator of inflammation, is involved in the development of post-operative complications. Thus, we sought to determine the role of HMGB1 in reflecting POCD following major gastrointestinal surgery. ⋯ Serum HMGB1 and IL-6 levels increase significantly after major gastrointestinal surgery in elderly patients and such elevations are associated with the occurrence of cognitive decline after surgery.
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The bone & joint journal · Jul 2014
ReviewC5 nerve root palsy following decompression of the cervical spine: a systematic evaluation of the literature.
C5 nerve root palsy is a rare and potentially debilitating complication of cervical spine surgery. Currently, however, there are no guidelines to help surgeons to prevent or treat this complication. We carried out a systematic review of the literature to identify the causes of this complication and options for its prevention and treatment. ⋯ Although many possible causes were given, most authors supported posterior migration of the spinal cord with tethering of the nerve root as being the most likely. Early detection and prevention of a C5 nerve root palsy using neurophysiological monitoring and variations in surgical technique show promise by allowing surgeons to minimise or prevent the incidence of C5 palsy. Conservative treatment is the current treatment of choice; most patients make a full recovery within two years.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2014
Review[Subsyndromal delirium - Experiences from the psychiatry - expectations for postoperative management].
The phenomenon of delirium is well known since over 100 years. The anesthesiology has recognized that early detection and therapy results in significant improvement of postoperative clinical state of health of the patients. In the following article it will be discussed that it could be profitable to make a further step: threatening the subsyndromal delirium. Because there are only few experiences in anesthesiology, this thesis will be substantiated by datas from psychiatry.
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ANZ journal of surgery · Jul 2014
Perioperative hypothermia in patients undergoing major colorectal surgery.
Perioperative hypothermia occurs frequently and can have serious health-related and financial consequences. Despite multiple warming methods available, perioperative hypothermia remains prevalent. To be effective, preventative measures must be timely and target patients most at risk. The aim of this retrospective review was to document the incidence and patterns of hypothermia in patients undergoing major colorectal surgery. ⋯ Mild hypothermia in patients undergoing major colorectal surgery is common, despite preventative measures. Core temperatures prior to commencement of the operation should be optimized with both active and passive warming measures, particularly for older patients and those arriving with lower core temperatures. Elective patients should also have their temperatures monitored as closely, if not more closely, than emergency patients. Preventing early declining trends in core temperature may positively influence later perioperative temperatures and improve outcomes.
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Anaesth Intensive Care · Jul 2014
The effect of patient sex on the incidence of early adverse effects in a population of elderly patients.
Patient sex is known to influence the response to general and regional anaesthesia and recovery after surgery. However, most studies come from analyses carried out on middle-aged patients. As most of the patients admitted to the post-anaesthesia recovery room in our institution are elderly, we took the opportunity to investigate the association between sex and incidence of early adverse events in this older population of patients after major surgery. ⋯ Women showed a higher incidence of shivering (relative difference +48%, P=0.0003), postoperative nausea and vomiting (+91%, P<0.0001), hypotension (+32%, P=0.044) and desaturation (+60%, P=0.0030) than men. The incidence of hypertensive response, arrhythmias and acute respiratory failure were not statistically significantly different. The findings of this exploratory study suggest that women have a higher risk of early postoperative adverse events even in a more elderly population.